Don’t Let Your Bladder Control You
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Do you have incontinence (leakage) if you don’t run to the bathroom as soon as you get home?
Do you go to the bathroom “just in case” every time you’re about to go somewhere?
If you feel like your bladder is running your life, try these tips to get better control.
Stay hydrated
A lot of people will cut back on drinking water if they have leakage or are going to the bathroom frequently, but this can actually make things worse. With less water intake, the urine in the bladder gets more acidic and can irritate the bladder, leading to more leakage, urgency, and frequency of having to go to the bathroom. Constipation can also make bladder symptoms worse, so increasing water to help with constipation can improve with your bladder health.
Drink water throughout the day to stay hydrated. Your urine should be a light “lemonade” yellow color. If it’s very dark yellow, you know that you’re not getting enough water. I love sipping water from my Hydro Flask water bottle throughout the day to stay hydrated!
Cut out bladder irritants
If you notice that your leakage, frequency, and/or urgency get worse after your morning coffee, consider cutting it out. Coffee is a bladder irritant, which means it can irritate the bladder and make symptoms worse. Other major bladder irritants include:
Acidic food and drinks – citrus, coffee, tea (herbal tea is ok)
Caffeinated drinks – coffee, tea, energy drinks
Carbonated drinks – carbonated water, energy drinks, soda
I’m not saying cut out all of your favorite things. But if you have a suspicion that what you’re drinking is making your bladder symptoms worse, try cutting it out completely (or even cutting back by ½) for a week and see if your symptoms are better. If they are, cut it out completely, try diluting the drink so it’s not as strong, or change what you’re drinking like a less acidic coffee like Lifeboost Coffee for example.
Stop going to the bathroom “just in case” all the time
If you just went to the bathroom 30 minutes ago and you’re about to go to the grocery store, don’t go to the bathroom “just in case”. You should be going to the bathroom every 2-4 hours with a full bladder. If you go more frequently and are voiding every time you’re about to leave the house, your bladder will start to learn that it needs to empty before it’s completely full and also be triggered to go every time you leave the house (even if it’s not full).
If you get the urge to go even though you just went to the bathroom, take several deep, calming breaths, perform several pelvic floor contractions (Kegels), and avoid going to the bathroom. This will help decrease the urgency to go to the bathroom and over time, will help retrain the bladder when it’s actually time to go to empty. *NOTE: if you have pelvic pain or have been told by your medical provider to not perform Kegels, focus on deep breathing and do not perform Kegels.
Control that urge
Bladder urgency is the strong sensation that you need to urinate immediately. If you are running to the bathroom as soon as you get home because your bladder is yelling at you to “go go go!”, then you can use the same strategy as described for going to the bathroom “just in case” above.
Before you put the key in the door to go inside your home, take several deep breaths, perform several pelvic floor contractions, and distract yourself. Once the urgency subsides, then go inside. If the urgency increases again, repeat the breathing, pelvic floor contractions, and distraction. It can be difficult to re-train the bladder initially, but keep at it! With repetition and time, your urgency and leakage will decrease to the point of you being able to control it.
Work with a pelvic health physical therapist (PT)
The above tips are general recommendations. To get optimal bladder health, work with a pelvic health PT. Pelvic health PTs are specially trained to treat abdominal and pelvic conditions. This includes the bladder, bowel, and sexual dysfunction, as well as any type of pain in these areas.
At your first pelvic health PT appointment for bladder issues, your physical therapist will ask you a lot of questions about your bladder habits. No need to feel embarrassed or hide things; the more we know, the better we can help you. You’ll be asked how often you go to the bathroom, how often you get up at night, if and when you leak (for example, are you leaking urine on your way to the bathroom, with coughing, or with intercourse), and what you’re drinking during the day. Your PT will also ask about any bowel or sexual health concerns.
After your PT has a better idea of what your symptoms are, a physical exam will be performed which often includes a pelvic exam. This pelvic exam does not include a speculum or stirrups, but it is an internal exam so that your PT can assess the pelvic floor muscles. These are a group of muscles at the bottom of the pelvis that helps to control the bladder and bowel, as well as having a sexual function and support function for the pelvic organs (bladder, rectum, and uterus). You always have the option to decline a pelvic exam based on your comfort level; talk to your PT about what options you have for your examination.
Once the physical exam is complete, your PT will give you homework to start managing your symptoms. Typically, people will attend pelvic health PT 1-2 times per week, depending on the condition and examination findings.
It’s time to get control of your bladder! Stop letting it run your life and work on retraining your bladder. To find a pelvic health PT near you, use the PT locator tools at APTA Pelvic Health or Herman and Wallace Pelvic Rehabilitation Institute.
